Home Care In Colwell, IA

Iowa must consider the appeals of a Council Bluffs dentist who says a Medicaid company is improperly denying payment for the services he provides to poor and elderly residents, the Iowa Supreme Court ruled Friday.

The government program is managed by private corporations and provides dental services to more than 155,000 Iowans.

If dentists can't appeal payment denials, fewer dentists will offer care under the Medicaid program, and more low-income Iowans won't get the care they need, the dentist's attorney argued.

Dentist Robert Colwell contends Delta Dental has for years denied him payment for tens of thousands of dollars in services he provided under the program.

And he says the Iowa Department of Human Services has failed in its responsibility to provide oversight of the for-profit company by refusing him a chance to appeal Delta Dental’s denials.

With no possibility of appeal to DHS, it's more difficult for doctors to challenge wrongful denials and maintain the financial solvency that allows them to provide services to the state’s poor, said Rebecca Brommel, Colwell’s attorney.

Friday’s ruling is a win for accountability, Brommel said.

“Doctors start to say, ‘I don’t want to deal with Medicaid or Delta Dental, so I’m not going to provide services to those patients at all,’” Brommel said. “That then creates an access-to-care problem.”

Segments of Iowa’s $60 million annual dental care program have been managed by two private companies — MCNA Insurance Co. and Delta Dental of Iowa — since 2014. Private management in the dental program expanded in 2017 and now covers almost all adult participants.

The expansion followed a larger shift by Iowa Gov. Terry Branstad in 2015 to privatize the overarching statewide $5 billion Medicaid program, which provides services to 600,000 people.

Hundreds of Iowans in the larger Medicaid program have been denied services since the privatization in situations that were not routinely denied when the state managed the program, doctors and patient advocates say. But in hundreds of those cases, patients were allowed to pursue an appeal through the DHS, and their cases were heard before an administrative law judge.

In Colwell’s case, DHS contended the issue was a contractual dispute between the dentist and the private company. DHS determined Colwell was not entitled to an administrative review, as is the case with individual patients.

Friday’s Supreme Court ruling affirms a Polk County District Court ruling that said Colwell is entitled to a hearing, as outlined in the state’s administrative rules. The ruling, however, reversed the district court’s judgment that awarded Colwell attorney fees.

Spokespeople for Delta Dental and DHS did not immediately respond Friday to requests for comment.

Another possible clue was revealed about the circumstances of Reiss Colwell's secret marriage in tonight's EastEnders (6th April).

Reiss was introduced into the BBC soap last December as a relative of Dot Branning (June Brown), and he quickly struck up a friendship and romance with Sonia Fowler (Natalie Cassidy). Reiss eventually moved in with her, but the awkward, gentle man was later seen taking a furtive phone call, in which he asked to speak to his wife.

Initially, it appeared that Reiss may be separated from the mysterious Mrs Colwell, but since then, more details have come to light...

The oblivious Sonia has been keen for Reiss to join her on a trip to Thailand to visit her daughter Bex (Jasmine Armfield); but Reiss resisted the idea, claiming not to have a valid passport. As Sonia arranged for them to go to the Passport office, Reiss squirmed.

Later, as he was accosted by Bailey Baker's (Kara-Leah Fernandes) global warming campaign, Reiss took a call from someone who was obviously not his wife - but the call was clearly about her as he asked if everything was okay.

"Well, I'm glad you're with her," he replied to the person on the other end of the line. "Yes, next Thursday - I'll be there, as per."

Later, Reiss was relieved when Sonia agreed to delay their plans after listening to Bailey's concerns for the planet. But his conversation about his wife has got us thinking about his double life. So, what is Reiss actually up to?

We've got spoilers, gossip and exclusive interviews for you.

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Well, the fact that he was talking to a third party about his spouse could suggest that Reiss's wife is being looked after in a care home. Might she have a long-term illness which leaves Reiss paying her regular visits rather than living with her on a permanent basis?

More like this

EastEnders boss teases "huge consequences" for Reiss Colwell lie

The fact that he was so hopeful about living with Sonia already hinted that his wife hasn't been at home waiting for him all this time. Viewers may recall that EastEnders has previously portrayed a similar story, when Ian Beale (Adam Woodyatt) first met Jane (Laurie Brett) and she revealed that her first husband, David Collins (Dan Milne), had Huntington's Disease and was living in a hospice.

So, is Reiss genuine in his feelings for Sonia, but lying to both her and his wife while he leads two separate lives; or is the truth even more complex than that?

Read more:

Visit our dedicated EastEnders page for all the latest news, interviews and spoilers. If you’re looking for more to watch, check out our TV Guide and Streaming Guide.

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Three Council Bluffs dentists allege a private nonprofit tapped to run a state dental insurance program for low-income Iowans is rejecting more claims than other insurers typically would, forcing them to provide substandard care.

Robert Colwell, Kate May and Richard Duvall have also filed a complaint with the Federal Trade Commission and the U.S. Justice Department, alleging they were illegally penalized as whistle-blowers for reporting problems with the program run by Delta Dental of Iowa.

The three, who also practice in nearby Bellevue, Neb., petitioned the Iowa Department of Human Services to have an administrative law judge interpret Delta Dental’s contract. That judgment, expected in about a month, will help decide whether Delta Dental acted within the law when it terminated the contract with the dentists in January with no cause.

Colwell says he and his associates withdrew a lawsuit this year in Polk County because it would have proven too expensive. Instead, he says, they are pursuing their case administratively through DHS to better protect the almost 136,000 members who have enrolled in the Dental Wellness Plan.

“The state should be stepping in on this, and it is not,” he said. “Enrollees are not getting the care they need.”

Jill Hamilton, a spokeswoman for Delta Dental, said the Johnston-based company denies all the dentists’ allegations.

She claimed neither Colwell nor any of his patients have appealed claims through Delta Dental’s or the state’s appeal process.

But Colwell says he and his colleagues have filed hundreds of online appeals over rejected claims. The problem, he says, is that unlike other insurers, Delta Dental requires that patients participate in appeals to proceed and many won't.

“We can’t even get some of our patients to show up for appointments,” he said.

Colwell says the company also requires many more narratives of cases for claims to be paid, placing a huge burden on dentists.

"They are trying to dictate to doctors how to practice dentistry, or they won't be paid," he said.

Iowa Medicaid contracted with Delta Dental of Iowa in May 2014 to provide comprehensive dental benefits for low-income, uninsured adults. The benefits are supposed to be equivalent to Medicaid’s current dental program, but members become eligible for enhanced benefits with regular follow-up exams.

Colwell contends that since Delta Dental began managing the program it has routinely rejected cases needing immediate attention.

“We have patients who have infections, deep decay or need a root canal. But under the contract with Iowa Medicaid, Delta Dental isn’t allowing these procedures,” Colwell said by way of an example.

Colwell alleged that in some cases decisions to deny claims are being made by dental hygienists, which is illegal.

But Hamilton said such decisions are made by licensed dentists with years of experience and the claims are denied because they do not meet clinical criteria.

I filed an open records request with DHS to see if any other dentists in Iowa have voiced similar complaints with Delta Dental.

Amy Lorentzen McCoy, a spokesperson for DHS in Iowa, said none have. “We are hearing the program is going really well,” she said.

Lorentzen McCoy declined to comment on the dentists’ allegations because of the pending petition with DHS.

According to Delta Dental’s last publicly filed tax return in 2013, the company had year-end assets of almost $60 million. At that time, the company’s president and CEO Jeff Russell made $256,633. That was before the company won the contract to administer the statewide program.

Columbia Threadneedle’s head of UK equities, Richard Colwell (pictured), will retire in November after over 30 years in industry.

He will be succeeded by Catherine Stanley, managing director of a specialist equities team, and head of equity research Jeremy Smith, who become co-heads of UK equities.

William Davies, global CIO, said: “Richard has had a long and successful career and leaves a strong franchise and track record of delivering for our clients. He has taken a long-term approach to investing, demonstrating clear stewardship over many years.

“As a major shareholder, he has helped guide a number of notable UK companies to deliver good outcomes for all stakeholders. We thank him for his contribution to our clients and our business and wish him well for his retirement.”

Colwell has led the CT UK Equity Income Fund since 2010, which has been continually featured on Bestinvest’s buy list.

Jason Hollands, managing director of Bestinvest, said: “Richard is without doubt one of the biggest beasts in the UK equity income space and his flagship CT UK Equity Income, which he has managed consistently since inception […], is one of the longest standing funds to have held a coveted place on Bestinvest’s Best Funds List. At £3.78bn, it is by some distance the largest fund in the IA UK equity income sector.”

Prior to joining Columbia Threadneedle, Colwell had stints at Schroders, Credit Suisse and Aviva Investors.

Richard Watts, Columbia Threadneedle CIO, EMEA, said: “We place significant emphasis on succession planning and I’m pleased that Catherine and Jeremy will be leading this expanded team, which brings together the existing UK equities and specialist equities teams.

“Together these two teams create one of the largest UK equities desks comprising 21 experienced investment professionals responsible for more than £20bn.

“We believe strongly in the sharing of research, debate and challenge, and the expanded team will bring broader perspectives for the benefit of investment decision making.”

Colwell is lead manager on four funds: CT UK Equity Income, CT UK Equity Alpha Income; CT UK Equity Growth and Income and Threadneedle (Lux) UK Equity Income and co-manager on CT Monthly Extra Income Fund alongside Alasdair Ross.

Jonathan Barber is deputy manager across all five strategies.

From the end of November, Smith will assume lead manager responsibility on the four funds solo-managed by Colwell, while Barber will step up to co-manage the CT Monthly Extra Income Fund alongside Ross, with Smith assuming the deputy role.

11 November 2022

Remaining level-headed during the good times and the bad will lead to a successful investing journey, according to the veteran fund manager.

Editor, Trustnet

Richard Colwell (pictured) is one of the most well-known figures in the UK asset management industry, having run the popular CT UK Equity Income fund for more than a decade.

The veteran stock picker is to retire at the end of the year, but before he leaves Trustnet sat down with him to find out how he has successfully navigated markets throughout his career and what investors can learn from his mistakes.

One key takeaway from his time at the helm of the second largest UK equity income fund is to not worry about getting things completely wrong.

Indeed, the manager pointed to his own mistake in not backing mining companies despite this being the best sector for returns among FTSE 100 companies in six of the past seven years.

“A lot of income managers profited, having bought very well when commodity prices fell aggressively at the end of 2015,” said Colwell.

However, he was convinced that he “had more time” and that the great commodity supercycle would underwhelm as Chinese growth stalled.

“I thought it would take time to work out,” said the CT UK Equity Income manager. “As it transpired there was another massive stimulus from the government in China and metal prices did extremely well.”

However, it is important that investors look at the entire picture, rather than just the binary call made on whether to buy or not.

Colwell said: “If you look at a decision in isolation it might look very poor or good, but it is how did you recycle the funds elsewhere, how did you reshape the portfolio. And also over what timeframe are considering the result?”

Indeed, some decisions can look foolhardy in the short term, but on a three-year view it could look like the right decision. In the case of commodities, the manager said he remains “convinced that my thesis is not unreasonable and could well play out” but concedes that he was at least six years too early. “So be it,” he added.

The other factor is what the opportunity cost of the investment was. For example, despite not owning commodities, since the start of 2016, the fund has performed broadly in line with the FTSE All Share index and beaten its average IA UK Equity Income peer by more than 14 percentage points, as the below chart shows.

Total return of fund vs sector and benchmark since start of 2016

Source: FE Analytics

“Do I beat myself up? No. The performance of the fund has been pretty reasonable despite that, which proves that it is about what you do own and having conviction on the companies where you think you have an edge rather than worrying about what you don’t own,” he said.

The behavioural aspect of investing is “as important if not more so than the intellectual debate”, he argued, and investors should not “obsess” over what they have done in the past as the decision has already been made.

“You want to celebrate the successes but don’t overdo it. But don’t catastrophise or beat yourself up too much when you go through a bad time of it,” the CT UK Equity Income manager said.

This can be used for all sorts of examples. While the above mining anecdote hinged on a macroeconomic factor, when it comes to picking stocks issues such as profit warnings or markets souring on a company also affect returns.

Unfortunately, these are part and parcel for investors, but there is a danger that they can internalise this as an individual error, rather than an unfortunate event.

“It is easy with hindsight and experience, but the key is not to confuse the result with the process. Sometimes you can have done good work, but events conspire. It doesn’t mean that the recommendation didn’t prevail outside of external issues that you didn’t foresee,” he said.

“The important lesson of that is to remain with your conviction and on the front foot. The worst thing you can do is become more timid in your investment views and your style as a fund manager.”

Colwell argued that by overdiversifying a portfolio, managers can inadvertently become like the index, something they are guaranteed to underperform once trading costs are taken into account.

“In the world we are in now where there is more money in passives and quant-driven ETF baskets, you have to stand for something different. It is an important role that an active manager has,” he said.

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equity income Income investing ISA section UK equities UK funds UK shares

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CT UK Equity Income

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Richard Colwell

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IA UK Equity Income

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